Serial fecal calprotectin changes in children with Crohnʼs disease on treatment with exclusive enteral nutritio

<p><b>Background:</b> Exclusive enteral nutrition (EEN) induces clinical remission in pediatric Crohn's disease (CD).</p> <p><b>Goals:</b> This study explored changes in fecal calprotectin concentration during treatment with EEN.</p> <p><b>Study:</b> Fecal calprotectin was measured in 4 serial stool samples from CD children during EEN. The Pediatric Crohn's Disease Activity Index (PCDAI) and systemic markers of disease activity were measured at the beginning and end of treatment.</p> <p><b>Results:</b> Fifteen CD children (7 girls; 11.6±2.3 y) participated. PCDAI decreased in 14 children and 7 children achieved clinical remission (PCDAI <=10). Fecal calprotectin concentration decreased (30 d, P=0.014; 60 d, P<0.0001) only in those children who entered clinical remission (PCDAI <=10). In the whole group mean calprotectin concentration at baseline (2158±642 mg/kg) was reduced by 975 mg/kg (95% confidence interval -1783; -167) after 30 days and 1700 mg/kg (95% confidence interval -2508; -892) on EEN completion. Only one child reached normal levels by the end of EEN. Decrease of pretreatment calprotectin levels by more than 18% after 30 days on EEN predicted clinical response at the end of EEN. Calprotectin levels at the end of EEN treatment did not predict the length of time lapsed to a future relapse.</p> <p><b>Conclusions:</b> In this pilot study calprotectin decreased in patients who achieved clinical remission and may be useful to predict response to treatment.</p&gt